Multi-mode cone beam CT radiotherapy simulator and treatment machine with a flat panel imager

Abstract

A multi-mode cone beam computed tomography radiotherapy simulator and treatment machine is disclosed. The radiotherapy simulator and treatment machine both include a rotatable gantry on which is positioned a cone-beam radiation source and a flat panel imager. The flat panel imager captures x-ray image data to generate cone-beam CT volumetric images used to generate a therapy patient position setup and a treatment plan.

What is claimed is: 
     
       1. A method to perform a clinical treatment, comprising:
 receiving a treatment plan at a computer of a radiation treatment machine; 
 storing reference image data on said computer; 
 positioning a patient at an initial position on a treatment couch of the radiation treatment machine; 
 rotating a gantry coupled to a frame of the radiation treatment machine; 
 emitting cone-beam radiation from a radiation source coupled to the gantry; 
 transmitting at least a portion of the cone-beam radiation through said patient; 
 capturing first image projection data using a flat-panel kV imager coupled to the gantry, wherein capturing the first image projection data includes capturing at least a portion of the portion of the cone-beam radiation transmitted through said patient; 
 generating cone-beam computed tomography (CT) volumetric image data from the first image projection data; 
 registering said cone-beam computed tomography (CT) volumetric image data with said reference image data; 
 repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment; 
 applying therapeutic radiation to a target volume using the treatment plan; 
 capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume; and 
 changing the speed of rotation of the gantry during rotation of the gantry. 
 
     
     
       2. The method of  claim 1 , wherein capturing the second image projection data includes capturing the second image projection data while changing the speed of rotation of the gantry during a continuous rotation of the gantry about the target volume. 
     
     
       3. A method to perform a clinical treatment, comprising:
 receiving a treatment plan at a computer of a radiation treatment machine; 
 storing reference image data on said computer; 
 positioning a patient at an initial position on a treatment couch; 
 rotating a gantry coupled to a frame of the radiation treatment machine; 
 emitting cone-beam radiation from a radiation source coupled to the gantry; 
 transmitting at least a portion of the cone-beam radiation through said patient; 
 capturing first image projection data using a flat-panel kV imager coupled to the gantry, wherein capturing the first image projection data includes capturing at least a portion of the portion of the cone-beam radiation transmitted through said patient; 
 generating cone-beam computed tomography (CT) volumetric image data from the first image projection data; 
 registering said cone-beam computed tomography (CT) volumetric image data with reference image data; 
 repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment; 
 applying therapeutic radiation to a target volume using the treatment plan; and 
 capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume at non-uniformly spaced angles with respect to rotation of the gantry. 
 
     
     
       4. The method of  claim 3 , wherein capturing the second image projection data includes continuously rotating the gantry about the target volume while capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry. 
     
     
       5. The method of  claim 4 , wherein capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry comprises predetermining non-uniformly spaced angles with respect to rotation of the gantry. 
     
     
       6. A method to perform a clinical treatment, comprising:
 receiving a treatment plan at a computer of a radiation treatment machine; 
 storing reference image data on said computer; 
 positioning a patient at an initial position on a treatment couch; 
 rotating a gantry coupled to a frame of the radiation treatment machine; 
 emitting cone-beam radiation from a radiation source coupled to the gantry; 
 transmitting at least a portion of the cone-beam radiation through said patient; 
 capturing first image projection data using a flat-panel kV imager coupled to the gantry; 
 generating cone-beam computed tomography (CT) volumetric image data from the first image projection data; 
 registering said cone-beam computed tomography (CT) volumetric image data with reference image data; 
 repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment; 
 applying therapeutic radiation to a target volume using the treatment plan; 
 capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume at non-uniformly spaced angles with respect to rotation of the gantry; and 
 wherein capturing the second image projection data includes changing the speed of rotation of the gantry during rotation of the gantry. 
 
     
     
       7. The method of  claim 6 , wherein capturing the second image projection data includes continuously rotating the gantry about the target volume (1) while capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry, and (2) while changing the speed of rotation of the gantry during rotation of the gantry. 
     
     
       8. The method of  claim 7 , wherein capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry comprises predetermining non-uniformly spaced angles with respect to rotation of the gantry. 
     
     
       9. A method to perform a clinical treatment, comprising:
 receiving a treatment plan at a computer of a radiation treatment machine; 
 positioning a patient at an initial position on a treatment couch of the radiation treatment machine; 
 rotating a gantry coupled to a frame of the radiation treatment machine; 
 emitting cone-beam radiation from a radiation source coupled to the gantry; 
 transmitting at least a portion of the cone-beam radiation through said patient; 
 capturing first image projection data using a flat-panel kV imager coupled to the gantry, wherein capturing the first image projection data includes capturing at least a portion of the portion of the cone-beam radiation transmitted through said patient; 
 generating cone-beam computed tomography (CT) volumetric image data from the first image projection data; 
 repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment; 
 applying therapeutic radiation to a target volume using the treatment plan; 
 capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume; and 
 changing the speed of rotation of the gantry during rotation of the gantry. 
 
     
     
       10. The method of  claim 9 , wherein capturing the second image projection data includes capturing the second image projection data while changing the speed of rotation of the gantry during a continuous rotation of the gantry about the target volume. 
     
     
       11. A method to perform a clinical treatment, comprising:
 receiving a treatment plan at a computer of a radiation treatment machine; 
 positioning a patient at an initial position on a treatment couch; 
 rotating a gantry coupled to a frame of the radiation treatment machine; 
 emitting cone-beam radiation from a radiation source coupled to the gantry; 
 transmitting at least a portion of the cone-beam radiation through said patient; 
 capturing first image projection data using a flat-panel kV imager coupled to the gantry, wherein capturing the first image projection data includes capturing at least a portion of the portion of the cone-beam radiation transmitted through said patient; 
 generating cone-beam computed tomography (CT) volumetric image data from the first image projection data; 
 repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment; 
 applying therapeutic radiation to a target volume using the treatment plan; and 
 capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume at non-uniformly spaced angles with respect to rotation of the gantry. 
 
     
     
       12. The method of  claim 11 , wherein capturing the second image projection data includes continuously rotating the gantry about the target volume while capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry. 
     
     
       13. The method of  claim 12 , wherein capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry comprises predetermining non-uniformly spaced angles with respect to rotation of the gantry. 
     
     
       14. A method to perform a clinical treatment, comprising:
 receiving a treatment plan at a computer of a radiation treatment machine; 
 positioning a patient at an initial position on a treatment couch; 
 rotating a gantry coupled to a frame of the radiation treatment machine; 
 emitting cone-beam radiation from a radiation source coupled to the gantry; 
 transmitting at least a portion of the cone-beam radiation through said patient; 
 capturing first image projection data using a flat-panel kV imager coupled to the gantry; 
 generating cone-beam computed tomography (CT) volumetric image data from the first image projection data; 
 repositioning the patient based on the cone-beam computed tomography (CT) volumetric image data, wherein repositioning the patient comprises moving said treatment couch prior to beginning the clinical treatment; 
 applying therapeutic radiation to a target volume using the treatment plan; 
 capturing second image projection data using a flat-panel MV imager coupled to the gantry, wherein capturing the second image projection data includes capturing at least a portion of the therapeutic radiation applied to the target volume at non-uniformly spaced angles with respect to rotation of the gantry; and 
 changing the speed of rotation of the gantry during rotation of the gantry. 
 
     
     
       15. The method of  claim 14 , wherein capturing the second image projection data includes continuously rotating the gantry about the target volume (1) while capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry, and (2) while changing the speed of rotation of the gantry during rotation of the gantry. 
     
     
       16. The method of  claim 15 , wherein capturing the second image projection data at non-uniformly spaced angles with respect to rotation of the gantry comprises predetermining non-uniformly spaced angles with respect to rotation of the gantry. 
     
     
       17. The method as in one of  claim 1 ,  3 ,  6 ,  9 ,  11  or  14 , further comprising adjusting a therapeutic radiation source into a position to align the target volume with the therapeutic radiation. 
     
     
       18. The method of  claim 17 , wherein said capturing first image projection data captures the first image projection data at a rate of at least 5 frames per second. 
     
     
       19. The method of  claim 17 , wherein said capturing first image projection data captures the first image projection data at a rate of at least 15 frames per second. 
     
     
       20. The method of  claim 17 , further comprising storing the treatment plan and the first image projection data on said computer. 
     
     
       21. The method of  claim 20 , further comprising displaying said first image projection data on a monitor. 
     
     
       22. The method of  claim 21 , further comprising using said second image projection data to verify that the target volume is properly targeted. 
     
     
       23. The method of  claim 20 , further comprising displaying said second image projection data on a monitor. 
     
     
       24. The method of  claim 23 , further comprising using said second image projection data to verify that the target volume is properly targeted. 
     
     
       25. The method of  claim 20 , further comprising displaying said cone-beam computed tomography (CT) volumetric image data on a monitor. 
     
     
       26. The method of  claim 25 , further comprising using said second image projection data to verify that the target volume is properly targeted. 
     
     
       27. The method of  claim 17 , further comprising using said second image projection data to verify that the target volume is properly targeted.